tag:blogger.com,1999:blog-4968787219619380438.post7768352350259481317..comments2023-09-21T04:02:29.457-04:00Comments on Skeptical Scalpel: Non-English-speaking patients. Lost in translation?Skeptical Scalpelhttp://www.blogger.com/profile/13206922456661320751noreply@blogger.comBlogger24125tag:blogger.com,1999:blog-4968787219619380438.post-75471855426474977302014-09-04T06:43:08.582-04:002014-09-04T06:43:08.582-04:00Allen, thanks for the comment. Great story. I'...Allen, thanks for the comment. Great story. I've used the double handset. As I said in the post, it's OK, but far inferior to a person-to-person conversation.Skeptical Scalpelhttps://www.blogger.com/profile/13206922456661320751noreply@blogger.comtag:blogger.com,1999:blog-4968787219619380438.post-75259771881276737412014-09-04T05:36:58.952-04:002014-09-04T05:36:58.952-04:00I went to an Insurance Company closed-case event s...I went to an Insurance Company closed-case event several years ago, so as not to re-create errors the insurance company has paid for once.<br /><br />As it was related, the doctor was trying to relate something complicated, but had trouble with the interpretation, so they got the housekeeper to translate.<br /><br />The found out in the depositions that after the first couple of rounds of interpretations the housekeeper started telling the patient and family 'you need to get a lawyer and sue'. So, housekeepers are out...<br /><br />We use double handset phones, and they're okay but not as good as in-person interpreters.Allenhttps://www.blogger.com/profile/07007303301883671920noreply@blogger.comtag:blogger.com,1999:blog-4968787219619380438.post-84640016863023758432014-02-14T07:16:04.010-05:002014-02-14T07:16:04.010-05:00Pepe (Jose) thanks for commenting. Good luck with ...Pepe (Jose) thanks for commenting. Good luck with your career.Skeptical Scalpelhttps://www.blogger.com/profile/13206922456661320751noreply@blogger.comtag:blogger.com,1999:blog-4968787219619380438.post-3465370927878315142014-02-13T23:57:22.738-05:002014-02-13T23:57:22.738-05:00As a med student I had the opportunity to make a c...As a med student I had the opportunity to make a couple of clerkships in the US and had no trouble translating for the spanish-speaking patients. It was a great experience and accounted for a different patient-doctor relashionship.<br /><br />As for the comment from anon I don't think it's fair to compare why the reasons why an immigrant with low education and economic background to someone who has spent more that years getting grad education. <br /><br />Jose, surgical resident from MexicoPepehttps://www.blogger.com/profile/17215108200828025085noreply@blogger.comtag:blogger.com,1999:blog-4968787219619380438.post-13084773771690554312014-02-10T14:54:09.141-05:002014-02-10T14:54:09.141-05:00Yes, Google translate is pretty good, but far from...Yes, Google translate is pretty good, but far from perfect. Isn't it a bit awkward to type on the iPad and then have the patient read it and vice versa? It also assumes the patient can read.<br /><br />I guess it's better than nothing.Skeptical Scalpelhttps://www.blogger.com/profile/13206922456661320751noreply@blogger.comtag:blogger.com,1999:blog-4968787219619380438.post-75663604250532279922014-02-10T14:30:03.872-05:002014-02-10T14:30:03.872-05:00Sometimes and in spite of your best efforts, resou...Sometimes and in spite of your best efforts, resources cannot provide you with an interpreter in a timely manner. Google translate on the iPad it iPod has been a 'life saver' on these occasionsHenry Woohttps://www.blogger.com/profile/10824214593614312990noreply@blogger.comtag:blogger.com,1999:blog-4968787219619380438.post-80918690674938189572014-01-25T08:25:32.415-05:002014-01-25T08:25:32.415-05:00Thank you both for contributing to the discussion....Thank you both for contributing to the discussion. I see no reason not to do detailed background checks on doctors and nurses. Skeptical Scalpelhttps://www.blogger.com/profile/13206922456661320751noreply@blogger.comtag:blogger.com,1999:blog-4968787219619380438.post-61130479839830449262014-01-24T20:47:50.338-05:002014-01-24T20:47:50.338-05:00I applied for a TN license last year, and a backgr...I applied for a TN license last year, and a background check and fingerprinting was part of it. I don't have a problem with it, but of course my record was clean. artigerhttps://www.blogger.com/profile/13361655152970244221noreply@blogger.comtag:blogger.com,1999:blog-4968787219619380438.post-59848871105467048272014-01-24T15:30:49.457-05:002014-01-24T15:30:49.457-05:00This prob. may make for an interesting separate th...This prob. may make for an interesting separate thread, but...<br /><br />I know that in CA, MD's and RN's get a background check on initial license application. Many hospitals (?percentage) also run them before hiring/granting privileges. <br /><br />The LA Times in the past year or so ran a bunch of articles about criminals maintaining their RN licenses. In response, I think the Nursing Board may start to run background checks upon renewals. The Medical Board already gets notice of arrests and convictions of doctors.<br /><br />When I applied for a Washington State MD license 4-5 years ago, I had to submit fingerprints for a state and FBI check. <br /><br />With the ease of collating data, it is just a matter of time before everyone's past is publicly available. <br /><br />Anonymousnoreply@blogger.comtag:blogger.com,1999:blog-4968787219619380438.post-69242215423634003162014-01-24T14:49:40.046-05:002014-01-24T14:49:40.046-05:00Very interesting. Thank you for commenting. I wond...Very interesting. Thank you for commenting. I wonder how widespread the practice is?Skeptical Scalpelhttps://www.blogger.com/profile/13206922456661320751noreply@blogger.comtag:blogger.com,1999:blog-4968787219619380438.post-79304459984010487252014-01-24T13:32:43.007-05:002014-01-24T13:32:43.007-05:00In the 2 states I have worked recently (West Coast...In the 2 states I have worked recently (West Coast) as a locums, it is becoming common to have a background check prior to medical staff credentialing. For the last one, I was curious and asked what exactly was checked. <br /><br />The employment screening company used had several tiers of services, and this hospital opted for a mid-level one. It checks for state criminal records, individual county criminal records for your counties of residence for the past 7 years, and national sex-offender databases. But, the hospital consent form I signed also authorize credit checks and was basically open-ended.<br /><br />I got a copy of this check, and although I was clean they did list all my previous addresses. <br /><br />Several other hospitals also ran background checks, although their details. These screening agencies are big business these days, and for high fees they can really find out everything about you.<br /><br />As far as I know, the hospitals run the same checks on their permanent staff applicants.<br /><br />This is of course in addition to the usual inquiries into medical and previous hospital credentials.<br /><br />Anonymousnoreply@blogger.comtag:blogger.com,1999:blog-4968787219619380438.post-55935212818225752072014-01-24T13:06:45.327-05:002014-01-24T13:06:45.327-05:00Thank you for that information. I have worked in 3...Thank you for that information. I have worked in 3 states and unless it was done without my knowledge, I have never undergone such a check. I don't know of any other physicians who have either.Skeptical Scalpelhttps://www.blogger.com/profile/13206922456661320751noreply@blogger.comtag:blogger.com,1999:blog-4968787219619380438.post-64674015175593974262014-01-23T15:56:50.834-05:002014-01-23T15:56:50.834-05:00Just a side note as an RN, at least in the state o...Just a side note as an RN, at least in the state of MD, we are subjected to background checks. Whether it is FBI, state police or what I don't know but when I graduated nursing school in 2007 we were the first class to have to do this and they were phasing in all RN's over the next several years. Just FYI.Anonymousnoreply@blogger.comtag:blogger.com,1999:blog-4968787219619380438.post-60146802087331000892014-01-21T22:36:12.882-05:002014-01-21T22:36:12.882-05:00Anon, very true and thanks. It's handy to know...Anon, very true and thanks. It's handy to know how to speak English. <br /><br />Artiger, thanks for the reality check. I'm sure what happens at your hospital takes place thousands of times per day across the US.Skeptical Scalpelhttps://www.blogger.com/profile/13206922456661320751noreply@blogger.comtag:blogger.com,1999:blog-4968787219619380438.post-70512635378109190582014-01-21T18:41:16.780-05:002014-01-21T18:41:16.780-05:00I try to view this realistically, as Anon above st...I try to view this realistically, as Anon above stated very well, but I have noticed that the Spanish-speaking patients in my rural area (Mid South) will almost always bring along an interpreter to their office visit. And they do so happily. It is often a family member, sometimes a friend, but occasionally someone they didn't know but were referred to by a friend or relative. <br /><br />I know that doesn't satisfy Joint Commission and all the other busybodies, but it's effective and efficient for us. I can't see it changing around these parts. artigerhttps://www.blogger.com/profile/13361655152970244221noreply@blogger.comtag:blogger.com,1999:blog-4968787219619380438.post-66947314385257031992014-01-21T17:43:56.842-05:002014-01-21T17:43:56.842-05:00Let me be politically incorrect here:
I lived and...Let me be politically incorrect here:<br /><br />I lived and worked in CA, but am now semi-retired. <br /><br />We should and do try our best to get interpreters. In many instances, it is logistically convoluted.<br /><br />The major non-English language in CA is Spanish. But, even in large Hispanic communities, few of the doctors and nurses can speak Spanish outside of cursory greetings. "Do you have pain?" is answered with long replies which lead us to a loss.<br /><br />I've had several patients (in a county hospital) who asked me why I don't speak Spanish. Since they were 30-40 year olds who had been in the US for years, I wondered why they can't speak English. <br /><br />I've treated a patient (injured at work) who spoke only a dialect used in rural Myanmar. Fortunately, he was accompanied by the only guy in the entire county who speaks both English (not well) and the Burmese dialect. Did I call ATT? No.<br /><br />If a patient does not understand English well and does not speak the native language of his physician/nurse, he will be at a disadvantage. That is just the way it is.Anonymousnoreply@blogger.comtag:blogger.com,1999:blog-4968787219619380438.post-23867501214369359292014-01-20T21:24:00.769-05:002014-01-20T21:24:00.769-05:00Anon, thanks. You would think that common sense wo...Anon, thanks. You would think that common sense would prevail, but when it comes to hospital administrators, that is not always the case. I wish I could tell you how to solve this problem, but it is beyond me.Skeptical Scalpelhttps://www.blogger.com/profile/13206922456661320751noreply@blogger.comtag:blogger.com,1999:blog-4968787219619380438.post-4544792690781130652014-01-20T20:56:39.660-05:002014-01-20T20:56:39.660-05:00The hospital where I work will not allow physician...The hospital where I work will not allow physicians to act as interpreters, even in their native languages. I have seen instances where docs have had to wait for 30 minutes or more to be connected with a medical interpreter on the phone when they could simply be obtaining a consent. It is a silly waste of time and valuable resources. Isn't there an easy way to certify mutlilingual staff who are medically trained? Anonymousnoreply@blogger.comtag:blogger.com,1999:blog-4968787219619380438.post-17547336928954397502014-01-20T11:55:13.746-05:002014-01-20T11:55:13.746-05:00Sound like what you are doing is a great idea. I h...Sound like what you are doing is a great idea. I have no personal experience with trying to see if a hospital would cooperate with your efforts. I suggest you call their public affair or public relations departments. Good luck.Skeptical Scalpelhttps://www.blogger.com/profile/13206922456661320751noreply@blogger.comtag:blogger.com,1999:blog-4968787219619380438.post-66244102202692756852014-01-20T10:24:42.175-05:002014-01-20T10:24:42.175-05:00I'm in a CERT group. CERT = Community Emergenc...I'm in a CERT group. CERT = Community Emergency Response Team. When there is a crisis and the fire/police/etc. are overwhelmed (as in a hurricane, floods), we do basic triage and helping out until the real medical people get here. We do have nurse volunteers, doctor volunteers. That being said, one of the things I'm putting together here are some phrases that we can use to get a dialogue going to help us out. The local university has a lot of foreign students. We have a few other resources, and I'm going to use that to put together something so that if we are "activated" we can do some sort of speaking with people and alert the medical personnel that we have someone who doesn't speak English (or very well). <br /><br />Has any one tried working with a hospital for their resources so we can point them in the right direction? If they have German at one hospital and not another, that's something we need to know, so we can send that patient to that particular hospital. Treatment would be delayed if we can't communicate. Anonymousnoreply@blogger.comtag:blogger.com,1999:blog-4968787219619380438.post-52960548440941221262014-01-17T21:05:19.279-05:002014-01-17T21:05:19.279-05:00You are fortunate to have so many resources and so...You are fortunate to have so many resources and so many staff fluent in Spanish. I could be wrong, but I think your entire situation is not the norm. Your patients are lucky too. Congrats. Skeptical Scalpelhttps://www.blogger.com/profile/13206922456661320751noreply@blogger.comtag:blogger.com,1999:blog-4968787219619380438.post-85973124565018311302014-01-17T18:43:16.912-05:002014-01-17T18:43:16.912-05:00At our institution. we have cracked down on the us...At our institution. we have cracked down on the use of "impromptu interpreters" across services with a possible exception of emergency surgery/trauma (procurement time is an issue but this is being addressed.) It's rare that a patient will be consented to a procedure or seen in clinic through non-clinical personnel. It certainly helps that a large contingent of staff here are fluent in Spanish.<br /><br />I've noted that after we adopted mobile video-interpreter units (TV on a cart with a microphone and camera, on speakerphone, connected to a certified interpreter) staff feel much more at ease communicating with their patients in depth.<br /><br />Personally, I find that my Spanish-speaking patients tend to understand treatment plans and verbalize a good knowledge of their condition(s) - more so on average than English-speaking patients of similar socioeconomic status. I don't know if this is because the terminology is inherently more precise in Spanish versus English, or if I'm explaining concepts in simpler terms in Spanish. My experience is probably not the norm, however.Anonymousnoreply@blogger.comtag:blogger.com,1999:blog-4968787219619380438.post-91053405189176491732014-01-17T14:40:50.807-05:002014-01-17T14:40:50.807-05:00I agree. Don't forget housekeeping under #2.I agree. Don't forget housekeeping under #2.Skeptical Scalpelhttps://www.blogger.com/profile/13206922456661320751noreply@blogger.comtag:blogger.com,1999:blog-4968787219619380438.post-46461919345342471382014-01-17T14:25:29.701-05:002014-01-17T14:25:29.701-05:00Despite all rules and regulations, in most places ...Despite all rules and regulations, in most places we still use:<br /><br />1) family<br /><br />2) nurses and aides on the ward<br /><br />3) hospital-employed and certified on-site interpreters (they are the best but not readily available and not after-hours).<br /><br />4) non-clinical personnel<br /><br />5) phone interpreters: great in theory but horrible in practice.<br />Anonymousnoreply@blogger.com